Abstract
Objectives
To describe the infectious and non-infectious complications in men undergoing IPP
revision with partial and complete component exchange for mechanical malfunction.
Methods
We performed a multicenter retrospective cohort study of patients who underwent IPP
revision. Men undergoing procedures for implant infection were excluded. Patients
were divided into those who had complete exchange of the entire device or partial
exchange of only one or two components. Infectious and non-infectious complications
were compared between groups.
Results
368 men had complete exchange of the entire device and 85 had partial component exchange.
Men undergoing partial exchange had a significantly higher infection rate (7.1% vs
2.2%, p=0.031). The partial exchange group also was more likely to receive antifungals
(51.8 vs 16.6%, p<0.001), have a modified salvage washout (77.4 vs 60.2%, p=0.004),
and less likely to receive vancomycin and gentamicin (63.5 vs 83.7%, p<0.001). Time
to revision was significantly shorter in the partial exchange group (44.9 vs 168.2
months, p<0.001). Mean follow-up was slightly longer in the complete exchange group
(18.3 vs 13.0 months). In multivariable analysis, partial exchange surgery, vancomycin
and gentamicin prophylaxis, modified salvage washout, and antifungal prophylaxis were
no longer associated with postoperative infections. The partial exchange group had
greater rates of non-infectious complications (21.2% vs 9.5%, p=0.005) such as pump
malfunction and tubing breakage.
Conclusions
Patients undergoing partial component revision had more infectious and non-infectious
complications. These findings suggest that partial component exchange increases complications
in men undergoing IPP revision.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Comparison of satisfaction rates and erectile function in patients treated with sildenafil, intracavernous prostaglandin E1 and penile implant surgery for erectile dysfunction in urology practice.J Urol. 2003; 170: 159-163https://doi.org/10.1097/01.ju.0000072524.82345.6d
- Comparison of Long-Term Results and Couples’ Satisfaction with Penile Implant Types and Brands: Lessons Learned From 883 Patients With Erectile Dysfunction Who Underwent Penile Prosthesis Implantation.J Sex Med. 2019; 16: 1092-1099https://doi.org/10.1016/j.jsxm.2019.04.013
- Inflatable Penile Prosthesis: Considerations in Revision Surgery.Curr Urol Rep. 2019; 20: 1-7https://doi.org/10.1007/s11934-019-0881-9
- Long-Term Follow-Up After Penile Prosthesis Implantation—Survival and Quality of Life Outcomes.J Sex Med. 2019; 16: 1827-1833https://doi.org/10.1016/j.jsxm.2019.08.001
- Artificial urinary sphincter mechanical failures - Is it better to replace the entire device or just the malfunctioning component?.J Urol. 2016; 195: 1523-1528https://doi.org/10.1016/j.juro.2015.10.084
Campbell SP, Kim CJ, Allkanjari A, et al. Infection rates following urologic prosthetic revision without replacement of any device components compared to partial or complete device exchange : a single-center retrospective cohort study. 2022;(September). doi:10.1038/s41443-022-00616-x
- Management of artificial urinary sphincter dysfunction.Eur Urol. 2004; 46: 241-246https://doi.org/10.1016/j.eururo.2004.01.017
- Artificial urinary sphincter troubleshooting.Urology. 2001; 58: 779-782https://doi.org/10.1016/s0090-4295(01)01388-7
- An outcomes analysis of over 200 revision surgeries for penile prosthesis implantation: A multicenter study.J Sex Med. 2012; 9: 309-315https://doi.org/10.1111/j.1743-6109.2011.02524.x
- Biofilm and Infectious Agents Present at the Time of Penile Prosthesis Revision Surgery: Times Are a Changing.Sex Med Rev. 2017; 5: 236-243https://doi.org/10.1016/j.sxmr.2017.01.002
- Cultures From Genitourinary Prostheses at Reoperation: Questioning the Role of Staphylococcus Epidermidis in Periprosthetic Infection.J Urol. 1995; 154: 387-390https://doi.org/10.1016/S0022-5347(01)67058-7
- Risk of Infection With an Antibiotic Coated Penile Prosthesis at Device Replacement for Mechanical Failure.J Urol. 2006; 176: 2471-2473https://doi.org/10.1016/j.juro.2006.08.010
- Contemporary revision penile prosthesis surgery is not associated with a high risk of implant colonization or infection: A single-surgeon Series.J Sex Med. 2011; 8: 1540-1546https://doi.org/10.1111/j.1743-6109.2011.02222.x
- Revision washout decreases penile prosthesis infection in revision surgery: A multicenter study.J Urol. 2005; 173: 89-92https://doi.org/10.1097/01.ju.0000146717.62215.6f
- Biofilm Formation on Clinically Noninfected Penile Prostheses.J Urol. 2006; 176: 1008-1011https://doi.org/10.1016/j.juro.2006.04.034
- Distance From Critical Pelvic Structures: Radiographic Comparison of High Submuscular and Space of Retzius IPP Reservoir Placement Techniques.Urology. 2022; 160: 136-141https://doi.org/10.1016/j.urology.2021.11.034
- Fate of the retained reservoir after replacement of 3-piece penile prosthesis.J Urol. 2004; 172: 664-666https://doi.org/10.1097/01.ju.0000131454.51640.a3
- Intentionally Retained Pressure-Regulating Balloon in Artificial Urinary Sphincter Revision.J Sex Med. 2013; 10: 2566-2570https://doi.org/10.1111/j.1743-6109.2012.02914.x
- Safety of the “drain and retain” option for defunctionalized urologic prosthetic balloons and reservoirs during artificial urinary sphincter and inflatable penile prosthesis revision surgery: 5-year experience.Urology. 2013; 82: 1436-1439https://doi.org/10.1016/j.urology.2013.07.038
- Isolated infection of a decommissioned penile prosthesis reservoir with actinomyces neuii.J Sex Med. 2011; 8: 923-926https://doi.org/10.1111/j.1743-6109.2010.02144.x
Article info
Publication history
Accepted:
November 22,
2022
Received:
October 14,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Source of Funding: None
Identification
Copyright
Published by Elsevier Inc.
